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https://www.readbyqxmd.com/read/28821992/analysis-of-outcome-at-discharge-after-aneurysmal-subarachnoid-hemorrhage-in-japan-according-to-the-japanese-stroke-databank
#1
Fusao Ikawa, Masaru Abiko, Daizo Ishii, Jyunpei Ohshita, Toshinori Matsushige, Takahito Okazaki, Shigeyuki Sakamoto, Eisuke Hida, Shotai Kobayashi, Kaoru Kurisu
The outcomes at discharge for ruptured cerebral aneurysms after subarachnoid hemorrhage (SAH) were investigated using data from the Japanese stroke databank. Among 101,165 patients with acute stroke registered between 2000 and 2013, 4693 patients had SAH caused by ruptured saccular aneurysm. Of these, 3593 patients (1140 men and 2453 women; mean age 61.3 ± 13.7 years) were treated by surgical clipping (SC) and/or endovascular coiling (EC). The outcomes of modified Rankin scale (mRS) at discharge were compared between the SC and EC groups...
August 19, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28821628/frontline-adapt-therapy-to-treat-patients-with-symptomatic-m2-and-m3-occlusions-in-acute-ischemic-stroke-initial-experience-with-the-penumbra-ace-and-3max-reperfusion-system
#2
Jens Altenbernd, Oliver Kuhnt, Svenja Hennigs, Ruediger Hilker, Christian Loehr
BACKGROUND: After a series of positive studies for mechanical thrombectomy in large vessel occlusion acute ischemic stroke, the question remains, can symptomatic patients with distal vessel occlusion benefit from mechanical thrombectomy? PURPOSE: To assess the safety and efficacy of the 3MAX reperfusion system as frontline therapy for M2 and M3 occlusions. METHODS: This study retrospectively collected data on 58 patients treated for M2 and M3 occlusions between January and September 2016...
August 18, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28819935/plasma-biomarkers-of-inflammation-reflect-seizures-and-hemorrhagic-activity-of-cerebral-cavernous-malformations
#3
Romuald Girard, Hussein A Zeineddine, Maged D Fam, Anoop Mayampurath, Ying Cao, Changbin Shi, Robert Shenkar, Sean P Polster, Michael Jesselson, Ryan Duggan, Abdul-Ghani Mikati, Gregory Christoforidis, Jorge Andrade, Kevin J Whitehead, Dean Y Li, Issam A Awad
The clinical course of cerebral cavernous malformations (CCMs) is highly variable. Based on recent discoveries implicating angiogenic and inflammatory mechanisms, we hypothesized that serum biomarkers might reflect chronic or acute disease activity. This single-site prospective observational cohort study included 85 CCM patients, in whom 24 a priori chosen plasma biomarkers were quantified and analyzed in relation to established clinical and imaging parameters of disease categorization and severity. We subsequently validated the positive correlations in longitudinal follow-up of 49 subjects...
August 17, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28819885/adenosine-assisted-clipping-of-intracranial-aneurysms
#4
Torstein R Meling, Luis Romundstad, Geir Niemi, Jon Narum, Per Kristian Eide, Angelika G Sorteberg, Wilhelm A Sorteberg
Temporary parent vessel clip occlusion in aneurysm surgery is not always practical or feasible. Adenosine-induced transient cardiac arrest may serve as an alternative. We retrospectively reviewed our clinical database between September 2011 and July 2014. All patients who underwent microsurgical clipping of intracranial aneurysms under adenosine-induced asystole were included. A total of 18 craniotomies were performed, and 18 aneurysms were clipped under adenosine-induced asystole (7 basilar arteries, 8 internal carotid arteries, 1 middle cerebral artery, and 1 anterior communicating artery) in 16 patients (10 females, 6 males)...
August 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28818585/-vitamin-k-in-the-neonate-recommendations-update
#5
J-M Hascoët, J-C Picaud, A Lapillonne, C Boithias-Guerot, P Bolot, E Saliba
Hemorrhagic disease of the newborn is not common but may be very serious, with cerebral, hepatic, or adrenal gland bleeding. Its prevention is based upon vitamin K1 administration from birth. Scientific studies to validate appropriate treatment policies are scarce, with recommendations coming from expert opinions, retrospective studies, or controversies on possible side effects. After analysis of recent literature data, we propose an oral administration of three doses of 2mg of vitamin K1 at birth, at discharge from the maternity ward, and at 1 month postnatal age for term infants...
August 14, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28818254/medical-treatment-strategies-to-reduce-perioperative-morbidity-and-mortality-after-carotid-surgery
#6
A Ross Naylor
There is a paucity of high-quality evidence regarding what constitutes "optimal medical therapy" for the purposes of reducing morbidity/mortality after carotid endarterectomy (CEA). All patients should be prescribed antiplatelet therapy. Low-dose aspirin (75 to 325 mg) should be continued throughout the perioperative period and there is no evidence that higher doses confer additional benefit. There is emerging evidence that early implementation of dual antiplatelet therapy in recently symptomatic patients (aspirin 75 mg plus clopidogrel 75 mg) can reduce recurrent cerebral events before CEA and that dual antiplatelet therapy will significantly reduce stroke due to early postoperative carotid thrombosis...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28816935/perimesencephalic-nonaneurysmal-subarachnoid-hemorrhage-caused-by-transverse-sinus-thrombosis-a-case-report-and-review-of-literature
#7
Fang-Wang Fu, Jie Rao, Yuan-Yuan Zheng, Liang Song, Wei Chen, Qi-Hui Zhou, Jian-Guang Yang, Jiang-Qiong Ke, Guo-Qing Zheng
RATIONALE: Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is characterized by a pattern of extravasated blood restricted to the perimesencephalic cisterns, normal angiographic findings, and an excellent prognosis with an uneventful course and low risks of complication. The precise etiology of bleeding in patients with PNSAH has not yet been established. The most common hypothesis is that PNSAH is venous in origin. Intracranial venous hypertension has been considered as the pivotal factor in the pathogenesis of PNSAH...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28816772/a-case-of-lenticulostriate-stroke-due-to-minor-closed-head-injury-in-a-2-year-old-child-role-of-mineralizing-angiopathy
#8
Emin Fidan, Dana D Cummings, Mioara D Manole
OBJECTIVE: Cerebral infarction due to minor head injury is rare. Mineralizing angiopathy is considered a predisposing factor for lenticulostriate stroke after minor closed head injury. This entity is characterized by infarction of the basal ganglia and most often occurs in young children, from infancy to 2 years of age. Symptoms usually occur immediately after the injury. METHODS AND RESULTS: We present the case of a previously healthy 2-year-old female child presenting with right facial hemiparesis and aphasia, along with right arm and leg weakness that occurred immediately after a fall from the couch onto a carpeted floor...
July 3, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28814371/dental-management-considerations-in-a-pediatric-patient-with-moyamoya-disease
#9
Htet Bo, David Avenetti, Evelina Kratunova
Moyamoya disease is a rare progressive cerebral arteriopathy associated with risk of ischemic and hemorrhagic brain complications. The dental care of affected individuals should be performed in a pain- and stress-free manner to decrease the chance of occurrence of episodes of hypocapnia, hypercapnia, hypotension, hypovolemia, and hypothermia. Dental treatment may be provided in an outpatient dental setting or in a hospital setting, but both venues require interdisciplinary collaboration to ensure safe delivery of patient care...
May 15, 2017: Journal of Dentistry for Children
https://www.readbyqxmd.com/read/28813763/simultaneous-onset-of-deep-vein-thrombosis-pulmonary-embolism-cerebral-infarction-and-myocardial-infarction-in-a-patient-with-patent-foramen-ovale
#10
Jimmy Yee, Vishesh Kumar, Alex Pham, Kashif Shaikh, Muhammad Omar, Adam Stys, Marian Petrasko
Paradoxical embolism is a known complication with intra-cardiac shunts. It should be considered in the differential as the pathophysiologic mechanism of simultaneous thromboembolism in the venous and systemic vasculature. We present a case of simultaneous deep venous thrombosis, pulmonary embolism and myocardial infarction in the presence of a confirmed patent foramen ovale on echocardiography. Thrombolytic therapy was administered. Subsequent concerns of intracranial hemorrhage on imaging of the brain complicated the management and added to the challenge of co-managing the clot burden in our patient...
June 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28812942/acute-hypertensive-response-in-patients-with-intracerebral-hemorrhage-pathophysiology-and-treatment
#11
Adnan I Qureshi, Mushtaq H Qureshi
Acute hypertensive response is a common systemic response to occurrence of intracerebral hemorrhage which has gained unique prominence due to high prevalence and association with hematoma expansion and increased mortality. Presumably, the higher systemic blood pressure predisposes to continued intraparenchymal hemorrhage by transmission of higher pressure to the damaged small arteries and may interact with hemostatic and inflammatory pathways. Therefore, intensive reduction of systolic blood pressure has been evaluated in several clinical trials as a strategy to reduce hematoma expansion and subsequent death and disability...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28812108/ultra-early-detection-of-microcirculatory-injury-as-predictor-of-developing-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#12
Philipp Gölitz, Philip Hoelter, Julie Rösch, Karl Roessler, Frauke Knossalla, Arnd Doerfler
PURPOSE: Delayed cerebral ischemia (DCI) still remains a major complication after subarachnoid hemorrhage (SAH). The aim of our study was to evaluate whether flow analysis of admission digital subtraction angiography (DSA) using parametric color coding (PCC), a postprocessing algorithm, allows ultra-early identification of SAH patients at risk for developing subsequent symptomatic vasospasm. METHODS: In this study 52 patients who suffered SAH from aneurysm rupture, were retrospectively enrolled...
August 15, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28808649/the-effect-of-a-single-dose-dantrolene-in-patients-with-vasospasm-following-aneurysmal-subarachnoid-hemorrhage
#13
Masih Sabouri, Mahmood Momeni, Fariborz Khorvash, Majid Rezvani, Homayon Tabesh
BACKGROUND: Cerebral vasospasm is a prolonged, occasionally severe, but reversible narrowing of the cerebral arteries that begins 3 to 5 days after the hemorrhage becomes maximal at 14 days. This study is designed to evaluate the effect of dantrolene on the reduction of vasospasm following aneurysmal subarachnoid hemorrhage (SAH). MATERIALS AND METHODS: This randomized controlled clinical trial was conducted on 32 patients with proven aneurysms in AL-Zahra hospital during 2011-2013...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28808606/middle-cerebral-artery-dissection-causing-subarachnoid-hemorrhage-and-cerebral-infarction-trapping-with-high-flow-bypass-preserving-the-lenticulostriate-artery
#14
Hideaki Ono, Tomohiro Inoue, Shinya Suematsu, Takeo Tanishima, Akira Tamura, Isamu Saito, Nobuhito Saito
BACKGROUND: Spontaneous intracranial arterial dissection (IAD) is an increasingly important cause of stroke, such as subarachnoid hemorrhage (SAH) and hemodynamic or thromboembolic cerebral ischemia. IAD usually occurs in the posterior circulation, and is relatively rare in the anterior circulation including the middle cerebral artery (MCA). Various surgical and endovascular methods to reduce blood flow in the dissected lesion have been proposed, but no optimum treatment has been established...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28808605/fatal-cerebral-swelling-immediately-after-cranioplasty-a-case-report
#15
Yuta Kaneshiro, Keiji Murata, Shigeru Yamauchi, Yumiko Urano
BACKGROUND: Cranioplasty is a standard neurosurgical procedure which is performed after decompressive craniotomy. Fatal complications associated with this procedure are not well documented. Here, we report a case of fatal cerebral swelling after cranioplasty and discuss the possible mechanism of this complication. CASE DESCRIPTION: A 64-year-old man was admitted with the diagnosis of cerebral hemorrhage, and emergency surgery for hemorrhage removal and decompressive craniotomy were performed...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28808603/aneurysm-treatment-practice-patterns-for-newly-appointed-dual-trained-cerebrovascular-endovascular-neurosurgeons-comparison-of-open-surgical-to-neuroendovascular-procedures-in-the-first-2-years-of-academic-practice
#16
Bowen Jiang, Matthew T Bender, Bima Hasjim, Frank P K Hsu, Rafael J Tamargo, Judy Huang, Geoffrey P Colby, Alexander L Coon, Li-Mei Lin
BACKGROUND: The practice patterns of a hybrid open cerebrovascular/neuroendovascular (CVNV) neurosurgeon in early academic practice is unknown. METHODS: We performed a multi-institutional retrospective cohort study of patients with cerebral aneurysms that were treated within the first 24 months of the neurosurgeon's practice. RESULTS: A total of 533 aneurysms were treated by the three senior authors within the first 24 months of their academic practice...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28805753/-prognostic-significance-of-leukocyte-count-in-the-venous-blood-in-the-acute-stage-of-cerebral-aneurism-rupture
#17
A A Kalinkin, S S Petrikov, L T Khamidova, V V Krylov
AIM: To determine a prognostic role of leukocyte count in the venous blood in the acute stage of cerebral aneurysm (CA) rupture. MATERIAL AND METHODS: Fifty-one patients with CA rupture, aged from 20 to 65 years, hospitalized in the first 72 h over the period from 01.10.12 to 01.02.16 were examined. The severity of disease and anatomical form of hemorrhage was corresponded to III-IV degree on the W. Hunt - R. Hess scale and Fisher scale. All patients underwent surgery...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28803179/bevacizumab-plus-radiosurgery-for-non-squamous-non-small-cell-lung-cancer-patients-with-brain-metastases-a-safe-combination
#18
J Guinde, R Carron, P Tomasini, L Greillier, J Régis, F Barlesi
INTRODUCTION: In the context of bronchial cancers, brain is one of the most frequent sites for metastases. Local treatments of these metastases have evolved and are often combined to obtain greater efficiency, the main objective remains to reduce the symptoms. Radiosurgery is currently used, as a primary option for patients harboring a small numbers of small to middle-sized brain metastases. In non-squamous non-small cell lung cancer (NSCLC), chemotherapy is often associated with bevacizumab...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28803174/intraoperative-vascular-neuromonitoring-in-patients-with-subarachnoid-hemorrhage-a-pilot-study-using-combined-laser-doppler-spectrophotometry
#19
Emilija Schmitz, Barbara Bischoff, Dennis Wolf, Hubert Schmitt, Ilker Y Eyupoglu, Karl Roessler, Michael Buchfelder, Björn Sommer
OBJECTIVE: Intraoperative monitoring of cerebral microcirculation in patients with subarachnoid hemorrhage (SAH) may predict the postoperative neurological outcome. In this pilot study, we examined the value of a novel non-invasive real-time measurement technique to detect changes in local microcirculation. METHODS: We used the laser-Doppler spectrophotometry system "Oxygen-to-see(O2C)" in 14 patients with SAH Hunt & Hess grade 2 to 5, who underwent microsurgical clipping of cerebral aneurysms...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28802549/diffuse-renal-cortical-hemorrhage-in-the-setting-of-subcapsular-hematoma-diagnosis-and-treatment-with-embolization
#20
Marta Burrel, Marta Barrufet, Maria Carme Sebastia, Jonathan Joudanin, Laura Buñesch, Patricia Bermudez, Jordi Blasco, Rosa Gilabert
PURPOSE: To describe radiologic findings, embolization technique, and clinical outcomes in patients with renal subcapsular hematoma and diffuse cortical hemorrhage. MATERIALS AND METHODS: Ten patients with renal subcapsular hematoma and diffuse cortical hemorrhage were reviewed. Nine of the 10 had undergone procedures (nephrostomy, n = 4; biopsy, n = 4; embolization of a cerebral aneurysm, n = 1) and 1 patient was receiving oral anticoagulation. Computed tomography (CT), angiography, and embolization of bleeding sites were performed in all patients...
August 9, 2017: Journal of Vascular and Interventional Radiology: JVIR
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